BARD CK PARASTOMAL HERNIA PATCH, MODELS 0118001, 0118002, 0118003, 0118004

K042026 · C.R. Bard, Inc. · FTL · Sep 10, 2004 · General, Plastic Surgery

Device Facts

• Record ID: K042026
• Device Name: BARD CK PARASTOMAL HERNIA PATCH, MODELS 0118001, 0118002, 0118003, 0118004
• Applicant: C.R. Bard, Inc.
• Product Code: FTL · General, Plastic Surgery
• Decision Date: Sep 10, 2004
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 878.3300
• Device Class: Class 2
• Attributes: Therapeutic

Intended Use

The Bard CK Parastomal Hernia Patch is indicated for use in the reconstruction of soft tissue deficiencies, such as for the repair of abdominal wall defects and hernias, including parastomal hernias.

Device Story

Self-expanding surgical mesh for hernia repair; consists of two-layered polypropylene mesh with extruded monofilament PET polymer memory recoil ring for stability; features ePTFE layer attached via PTFE monofilament interlocking stitch; includes off-center opening surrounded by ePTFE collar and slit to facilitate positioning around stoma; pockets on top layer assist in placement and fixation. Device is preshaped and presized for ready-to-use application. Used by surgeons in clinical settings for abdominal wall reconstruction. Provides structural reinforcement to repair defects; benefits patient by facilitating surgical repair of parastomal hernias.

Clinical Evidence

Bench testing only. Biocompatibility testing confirmed materials are non-toxic and non-sensitizing. Laboratory testing demonstrated that design and materials meet established specifications for consistent performance.

Technological Characteristics

Knitted polypropylene monofilament mesh; extruded monofilament PET polymer memory recoil ring; ePTFE layer; PTFE monofilament interlocking stitch. Preshaped/presized form factor. Non-absorbable synthetic materials.

Indications for Use

Indicated for reconstruction of soft tissue deficiencies, including repair of abdominal wall defects and hernias, specifically parastomal hernias.

Regulatory Classification

Identification

Surgical mesh is a metallic or polymeric screen intended to be implanted to reinforce soft tissue or bone where weakness exists. Examples of surgical mesh are metallic and polymeric mesh for hernia repair, and acetabular and cement restrictor mesh used during orthopedic surgery.

Predicate Devices

• Bard® Composix® Kugel® Mesh
• Gore® SEAMGUARD Staple Line Reinforcement Material (K001789)

Submission Summary (Full Text)

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K042026 P.1/3

# SEP 1 0 2004

### SECTION VII.

# 510(K) SUMMARY OF SAFETY AND EFFECTIVENESS FOR THE BARD® CKTM PARASTOMAL PATCH

#### Submitter Information A.

| Submitter's Name: | Davol Inc. |
|----------------------|--------------------------------|
| Address: | Subsidiary of C. R. Bard, Inc. |
| | 100 Sockanossett Crossroad |
| | Cranston, RI 02920 |
| Telephone: | 401-463-7000 ext. 2529 |
| Fax: | 401-463-3845 |
| Contact Person: | Karen S. Gwozdowski Gauvin |
| Date of Preparation: | July 27, 2004 |

### Device Name B.

| Trade Name: | Bard CK Parastomal Hernia Patch |
|----------------------|---------------------------------|
| Common/Usual Name: | Surgical Mesh |
| Classification Name: | Surgical Mesh, Polymeric |

#### C. Predicate Device Name

| Trade name: | Bard® Composix® Kugel® Mesh (Davol Inc.) |
|-------------|-----------------------------------------------------------------------------------|
| Trade name: | Gore® SEAMGUARD Staple Line Reinforcement Material (W.L. Gore & Associates, Inc.) |

### D. Device Description

The proposed device is a self-expanding, two-layered polypropylene mesh containing an extruded monofilament PET polymer "ring". The top layer of polypropylene mesh has two slits in it to form pockets. The purpose of the pockets is to facilitate placement, positioning and fixation of the device. The mesh is constructed from knitted polypropylene monofilament. The monofilament PET "ring" adds stability to the device facilitating placement and assurance in the proper placement of the patch. A single layer of expanded polytetrafluoroethylene (ePTFE) is attached to the polypropylene mesh. The attachment is accomplished with an interlocking stitch using polytetrafluoroethylene (PTFE) monofilament. The peripheral edge (excluding the off-center opening) of the polypropylene mesh is heat sealed to the ePTFE layer. An off-center opening in the proposed device accommodates the stoma and this opening

### CONFIDENTIAL

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K04202612/3

is surrounded by an ePTFE collar. The ePTFE collar is attached to the mesh side of the proposed device with an interlocking stitch using PTFE monofilament. A slit in the proposed device extends from the opening in the proposed device to the perimeter to facilitate positioning of the proposed device around the stoma. The proposed device is preshaped and presized to offer maximum ready-to-use benefits.

### Intended Use E.

The Bard CK Parastomal Hernia Patch is indicated for use in the reconstruction of soft tissue deficiencies, such as for the repair of abdominal wall defects and hernias, including parastomal hernias.

### Summary of Similarities and Differences in Technological F. Characteristics, Performance and Intended Use

The proposed device has the same exact materials as the predicate Composix Kugel, along with similar physical attributes, performance characteristics and manufacturing methods as the predicate Composix Kugel.

The difference between the proposed and predicate device includes the opening in the proposed device surrounded by the ePTFE collar and the slit in the proposed device to access the opening in the proposed device. The predicate device does not have an opening surrounded by an ePTFE collar and does not have a slit in the device. The shape of the memory recoil "ring" in the proposed device is different from the shape of the memory recoil "ring" in the predicate device.

The Gore SEAMGUARD Staple Line Reinforcement Material (K001789) indication includes the repair of hernias, including paracolostomy hernias. This indication is the same as the proposed device indication statement.

The proposed device is indicated for use in the reconstruction of soft tissue deficiencies, such as for the repair of abdominal wall defects and hernias, including parastomal hernias. The predicate Composix Kugel and the proposed device are both intended for use in hernia repair. The proposed device provides an additional example of a parastomal hernia. The parastomal hernia is part of the broader indication of a hernia. A hernia is part of a broader indication of soft tissue deficiency. Therefore, the predicate Composix Kugel and the proposed device have the same indication statement.

CONFIDENTIAL

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K042026
P3/3

### Performance Data G.

Biocompatibility and bench testing have been completed and support the safety and effectiveness of the Bard CK Parastomal Hernia Patch for its intended use.

The biocompatibility test results show that the material used in the design and manufacture of the device are non-toxic and non-sensitizing to biological tissues consistent with their intended use. Laboratory test results demonstrate that the materials chosen and the design utilized in manufacturing the Bard CK Parastomal Hernia Patch will meet the established specifications necessary for consistent performance during their intended use.

CONFIDENTIAL

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DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/3/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized eagle with three lines representing its wings and head. The eagle is enclosed in a circle with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" around the perimeter.

Public Health Service

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

SEP 1 0 2004

Ms. Karen S. Gwozdowski Gauvin Regulatory Affairs Associate Davol, Inc. 100 Sockanossett Crossroad Cranston, Rhode Island 02920

Re: K042026

Ro42020
Trade/Device Name: Bard® CK™ Parastomal Hernia Patch Regulation Number: 21 CFR 878.3300 Regulation Name: Surgical mesh Regulatory Class: II Product Code: FTL Dated: July 27, 2004 Received: July 28, 2004

Dear Ms. Gauvin:

We have reviewed your Section 510(k) premarket notification of intent to market the device wt nave reviewed your becamed the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate 101 ass stated in the May 28, 1976, the enactment date of the Medical Device Amendments, or to conniner of the that to ria) 20, 2011 accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). and Cosmetter recept inter, that be device, subject to the general controls provisions of the Act. The Fourmaly, dicrere, many of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to such additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must or car) i with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

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## Page 2 - Ms. Karen S. Gwozdowski Gauvin

This letter will allow you to begin marketing your device as described in your Section 510(k) premarket notification. The FDA finding of substantial equivalence of your device to a legally p arketed predicate device results in a classification for your device and thus, permits your device to proceed to the market.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Office of Compliance at [phone]. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). You may obtain other general information on your responsibilities under the Act from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number [phone] or [phone] or at its Internet address http://www.fda.gov/cdrh/dsma/dsmamain.html

Sincerely yours,

Miriam C. Provost

Celia M. Witten, Ph.D., M.D. Director Division of General, Restorative and Neurological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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# Indications for Use

510(k) Number (if known):

Device Name:

Indications for Use:

# Bard® CK™ Parastomal Hernia Patch

The Bard CK Parastomal Hernia Patch is indicated for use in the reconstruction of soft tissue deficiencies, such as for the repair of abdominal wall defects and hernias, including parastomal hernias.

Prescription Use _ X (Part 21 CFR 801 Subpart D) AND/OR

Over-The-Counter Use (21 CFR 807 Subpart C)

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

Muriam C. Provost

Division of General, Restorative, and Neurological Devices

**510(k) Number** K042026

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